BOOKING REQUEST FORM

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BOOKING REQUEST FORM

Use this form to book Bernice Loman, MBA for your next event. Expect a response within 2-3 business days.

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* Indicates required question

Name *

Your answer

Email *

Your answer

Phone Number *

Your answer

Name of Event & Description of Event. *

Your answer

What is the date of event that you're requesting for Bernice to speak? *

MM

/

DD

/

YYYY

What is the time of event that you're requesting for Bernice to speak? *

Time

:

AM

PM

Event Location/Address *

Your answer

How many people are you expecting to attend? *

Your answer

Engagement Request *

Keynote

Guest Speaker

Facilitator

Workshop Trainer

Panelist

Other

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